Effectiveness of Lighting Changes in Dementia Care Services

This article discusses the effectiveness of lighting changes in dementia care services. It highlights the importance of environmental modifications in promoting the overall wellbeing and quality of life of dementia patients. The article also provides evidence-based research on the benefits of lighting modifications in improving sleep patterns, reducing agitation and depression, and reducing fall rates among dementia patients.

Running head: DEMENTIA CARE
Assessment Details
SNPG 955 Dementia Care across Settings
Name of the Student
Name of the University
Author Note

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Introduction- The term dementia is an umbrella term that refers to a broad category of
mental diseases causing a long-term effect in the form of gradual decreasing the ability to
remember and think, thereby affecting daily functioning. Major symptoms in addition to the ones
stated above include language difficulties, emotional problems, and decrease in motivation
(Richardson et al. 2013). Thus, caring for people with dementia often encompasses several
aspects of formal and informal care. While formal care practices include support from friends,
family, and community members, informal care often refers to making architectural changes in
the place where the patients live. This helps in creating an environment that supports the overall
wellbeing and functioning of the elderly patients (McLaren, LaMantia and Callahan 2013).
Caring for dementia patients poses several challenges due to the fact that the patients most often
lose the power to speak or comprehend. Care approaches are therefore adopted in a way that
addresses the difficulties faced by the patients. According to research evidences, proportion of
older people suffering from dementia, living in households reduces with age. Furthermore,
estimates also indicate that approximately 81.1 million people will require appropriate residential
care facilities for dementia, by the year 2040 (Prince et al. 2013). Thus, bringing about changes
in the environmental design is gaining increasing attention as an essential aspect of care while
treating people suffering from dementia and Alzheimer’s disease. Designers and facility
administrators are now considering the long-term benefits of formulating design principles for
developing a dementia free environment. This part of the assignment will critically evaluate
effectiveness of changes in lighting as a part of dementia care services.
Literature review- Guidelines that determine design changes for a dementia free
environment typically discuss about several theories and hypothesis on the effectiveness of
physical environment modifications and spatial organization in promoting the overall wellbeing

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and quality of life of dementia patients. Most common modifications have been identified as
eliminating unnecessary clutters, removing paging systems, soft colours, creating familiar
spaces, reducing risks and eliminating noise (Schrijvers et al. 2012). Similar findings have been
elucidated by other researchers that suggested that residential facilities should be smaller in size,
with controlled stimuli related to noise and enhanced visual access. Dementia patients need to
visualize their environment for making an appropriate sense of their surroundings, to utilise most
of their remaining capabilities. According to research evidences, effective lighting has been
found to facilitate individuals with dementia to observe the places where they want to go for
identifying rooms, spaces, equipments and symbols (Fleming, Kelly and Stillfried 2015).
Furthermore, light modifications have been found to help them easily recognize faces of their
acquaintances, carers and physicians. It also facilitates easy identification of gestures and body
languages. Lighting modifications are responsible for increasing detailed contrast and apparent
size of all objects (Marquardt, Bueter and Motzek 2014). Poor lightning or light positioned at
inappropriate places often result in glare and reflect off polished floor surfaces or walls, thereby
creating difficulties for dementia patients to move on their own. Such lack of illumination or
glares is often considered dangerous for dementia patients since it increases risks of fall related
injuries.
According to research evidences, light therapy is considered as a promising non-
pharmacological method for improving symptoms associated with dementia. Evidences suggest
that the human circadian rhythm shows maximum sensitivity to short wavelength blue light for
therapeutic purposes. Tailored lighting was found to create significant improvements in
agitation, depression and sleep patterns among dementia patients (Figueiro et al. 2014). Effective
light intervention was also found to significantly bring about improvements in circadian

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entrainment, and sleep efficiency. Significant reductions in depressive symptoms were also
observed among dementia patients upon implementation of lighting interventions. Furthermore,
the caregivers have also been observed to experience longer sleep duration (Fleming and Bennett
2015). Other evidences were also successful in establishing the fact that physical environment
modifications play an essential role in the therapeutic environment for dementia patients. Role of
a well-designed and supportive physical environment has been shown to foster healthy behaviour
such as, enhanced social contact, reduced agitation and less dependence by dementia patients
(Figueiro et al. 2015). Research studies have also elucidated the importance of lighting for
changing the environment of people with dementia, such as, creating provisions for natural
lighting in circulating spaces and providing opportunities for natural and external views (Hadjri,
Faith and McManus 2012). Thus, maintenance of adequate balance between adequate and natural
light levels are useful for eliminating glares, and reducing risks of subsequent falls (Garre‐Olmo
et al. 2012). Moreover, good lighting has also been found to enhance the visual environment that
often results in an increase in optimism and renewed interest among the patients. This increases
their mobility and helps them to remain more active (Sury, Burns and Brodaty 2013). Cool-white
lights are often considered disadvantageous as they are deficient in blue and red lights and are
found to deteriorate the warmth and aliveness of the indoor spaces in which the patients are kept.
Discussion- On making several modifications in the environment in which the dementia
patients were provided with optimal care services, several positive impacts were observed. The
basic fact that older people suffering from Alzheimer’s disease and often require more amount of
light for maintaining visual and non-visual functions, was considered while making the
necessary environmental modifications. The major problems that were faced in the care setting
include high rates of falls among the patients that increased rates of hospitalizations due to

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severe injuries, and poor sleep quality and disturbances among them (Küller 2015). This directly
contributes to manifestation of agitation and hostile behaviour. Such problems generally
occurred due to poor lighting and led to development of confusion in their daily routines. Further
problems were also faced in the form of reduction in their activity levels and alertness, thereby
increasing frequencies of their daytime napping (Chaudhury and Cooke 2014). Hence, the action
plan was formulated that contained implementation of appropriate lighting modifications in the
care facility. Major achievements were associated with use of bright lights in the living and
indoor areas that showed a significant improvement in restoring the biological clock among the
people with dementia. It also resulted in elimination of dimly lit areas and significantly reduced
instances of suffering injurious or fatal falls. This showed direct impacts on restoring their
biological clock. Significant outcomes were related to regulating the sleep/wake cycle for 24
hours, in the older adults suffering with dementia (Wong et al. 2014).
The environmental modification also demonstrated a significant improvement in the
overall wellbeing and quality of life of the patients. This was evaluated by the fact that the
patients manifested fewer symptoms of agitation and depression, during and after the
intervention period. Initially disruption of the circadian rhythm due to poor lighting was found to
result in drastic changes in their sleep patterns. On the other hand, the aforementioned lighting
modification helped in making the older people more active and alert throughout the day. The
patients depicted increased productivity and showed better sleep patterns during night.
Furthermore, significant reductions were observed in daytime sleep patterns. Use of vibrant
colours in the walls of the rooms where the patients stayed resulted in influencing them to a great
extent that made the patients engage more in daily activities. Improved participation in indoor
activities was another observable change that made them enjoy themselves more during the day.

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In addition, less instances of night wandering and restlessness were reported, following the
modification in environmental design. Bringing about modifications in the environment also
helped in reducing use of pharmaceutical interventions such as, sleep inducing drugs that were
initially administered to restore sleep patterns among the patients to normal. Furthermore, the
older patients were found to participate more in their favourite activities, such as, gardening,
watching television and playing cards. Furthermore, some of the patients also demonstrated an
interest in participating in bush walking, under the supervision of the healthcare and support
workers, employed at the care home.
Conclusion- To conclude, it can be stated that direct benefits of the lighting changes
were associated with the fact that it made the elderly patients enjoy their life and accept its
vibrancy. The positive outcomes as observed by implementing the modifications such as,
maximizing natural light benefited the dementia patients to a great extent. Taking efforts to
install different types of artificial lighting and changing the positions of the lightings also help
them in entering and leaving their rooms and the care centre with much ease. Maintaining
appropriate uniformity and intensity of light in the care facility and controlling preferences of the
lighting while allowing the residents to have full choice and control in deciding the lighting
levels also improved their comfort. Hence, environmental modification based on lighting proved
to play an essential part in providing optimal care services to dementia patients. Use of good
lighting help them to utilise most of their capabilities and also compensated for their poor
eyesight. It assisted the patients to find their way around familiar and new spaces and also helped
them to undertake specific tasks, related to their daily activities or hobbies. Subsequent reduction
in fall rates was another major benefit that improved the overall health and well-being of the
patients and enhanced their satisfaction. Therefore, maintaining an environment that with

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dementia friendly did not necessarily involve huge installation costs or recruitment of builders.
Simple arrangements not only enhanced well being of all patients living with dementia, but
opportunity to the care providers for creating a sustainable living environment.

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